Results of the latest National Survey on Drug Use and Health show that some encouraging trends in substance use among youths and young adults in recent years are continuing. The 2025 survey data also demonstrate the critical importance of high-quality, responsive substance use treatment to address unmet need.
Released by the Substance Abuse and Mental Health Services Administration (SAMHSA) in late July, the 2025 self-report survey on behavioral health trends among youths and adults shows a continued pattern of stable or declining substance use in the youngest age groups. For example, despite ongoing concerns about the public’s perceived risk around marijuana use, both the 12-to-17 and 18-to-25 age groups showed declines in past-month use of marijuana in 2025.
Also, the prevalence of past-month alcohol use among those aged 12 to 20 continues to decline, from 15.6% in 2021 to 13.7% last year. Past-month underage binge drinking rates did not drop, however.
Another data point that behavioral health treatment programs have been paying close attention to involves patient suicide risk. The latest survey shows that while just over 10% of adolescent respondents had serious thoughts of suicide in the past year, that represents a decline from 2021. Meanwhile, the prevalence of suicide plans and attempts among adults in 2025 was slightly higher than in 2021.
The “treatment gap” between the number of individuals needing substance use treatment and the number receiving care remains a prominent concern. In 2025, only 16% of individuals classified as needing treatment received any services in the past year. For those with a diagnosable substance use disorder, fewer than 14% received any services to help with their substance use, according to the survey.
Among those who perceived a need for treatment but didn’t receive care, the most commonly cited reason for not receiving services was thinking they should have been able to handle their substance use on their own. This was followed in order by not being ready to quit or cut back on use, not being ready to start treatment, not having enough time for treatment, and being worried about others’ reactions to one’s treatment.
These findings speak to why so many substance use treatment programs have abandoned fixed models of care that don’t meet individual needs — and why those that haven’t should. Programs that truly live up to the notion of meeting patients where they are will be in the best position to succeed with reluctant clients.
The one-size-fits-all treatment model simply isn’t workable in treating complex substance use and mental health disorders. New Hampshire-based WestBridge, which has acquired a national reputation in treating young people with co-occurring disorders, is expanding its intensive outpatient program (IOP) offerings in August by launching an evening program track. The night program will have both in-person and virtual access options. In the industry as a whole, the idea of making the patient fit an existing program structure continues to give way to flexibility in service delivery.
The results of the National Survey on Drug Use and Health suggest that the nation’s effort to combat problematic substance use remains on the right track, but with more progress needed to attract hard-to-reach individuals.
